Recently, several Blue Cross plans that sponsor Health Maintenance Organizations (HMOs), among other insurance products, have sought regulatory approval to convert from a not-for-profit to a for-profit entity. We examine the impact of not-for-profit HMOs converting to for-profit status in a...

In the 1990s the US hospital industry consolidated. This paper estimates the impact of the wave of hospital mergers on welfare focusing on the impact on consumer surplus for the under-65 population. For the purposes of quantifying the price impact of consolidations, hospitals are modeled as an...

This paper comments on David Hyman's theory of fraud and abuse in medical care. It agrees with Hyman that preventing fraud is difficult because providers, patients, and program administrators usually have weak incentives to do so. It extends Hyman's work by arguing that the root cause of fraud...

This paper uses 1977 data from a national probability sample of 1,200 hospitals to estimate the effect of unions on wages and fringe benefits in four occupations: registered nurses, practical nurses, secretaries, and housekeepers. The results show that unionization has a significant impact on...

Recently, two large health maintenance organizations (HMOs) in Minneapolis merged to form a single company with over half of the total Twin Cities HMO enrollment. This paper strongly suggests that the merger will have adverse consequences for consumers. I use a model of health plan rivalry and...

This paper presents a theoretical framework to predict the effects that may arise from mergers in the rapidly-growing Medicare HMO market. We argue that mergers of large Medicare HMOs should be targeted for antitrust investigation because there are significant barriers into this market. The...

The Medicare Modernization Act of 2003 created several new types of private insurance plans within Medicare, starting in 2006. Some of these plan types previously did not exist in the commercial market and there was great uncertainty about their prospects. In this paper, we show that statistical...